Medical aspiration system

ABSTRACT

A medical vacuum aspiration system preferably for use in vacuum abortions and diagnostics. The system is designed for operation at high vacuum and includes a single transparent container which provides the reservoir of vacuum, the chamber for collecting the aspirated products, a trap for the collection of tissue and the handle for the cannula. The container is provided with a cap and valve on which the cannula is directly mounted. The invention also includes a preferred method for producing high vacuum inside of the chamber.

United States Patent 1191 1111 3,833,000 Bridgman Sept. 3, 1974 [5 MEDICAL ASPIRATION SYSTEM 3,542,031 11/1970 Taylor 128/276 Inventor: Henry Bridgman, P'O Box 3,661,144 5/1972 Jensen et al. 128/276 Convent Station, NJ. 07961 Prtmary Exammer--Charles F. Rosenbaum Flledi J 1972 Attorney, Agent, or FirmRoland Plottel [21] Appl. No.: 258,960

' [57 ABSTRACT U-S- C]- U... A medical vacuum aspiration ystem preferably use in vacuum abortions and diagnostics The system [58] held of Search 128/2 1316- DIG is designed for operation at high vacuum and includes 123/275-278 a single transparent container which provides the reservoir of vacuum, the chamber for collecting the aspi- [56] References Clted rated products, a trap for'the collection of tissue and UNITED STATES PATENTS the handle for the cannula. The container is provided 1,360,809 11 1920 Smith .j. 141/65 with a p and valve on which the cannula is directly 2,465,685 3/1949 Henderson 128/276 mounted. The invention also includes a preferred 3,143,109 8/1964 Gewertz 128/2 F method for producing high vacuum inside of the 3,l75,553 3/1965 Mattson l28/2 F chamber A 3,491,748 l/197O 3,515,135 6/1970 Flower et al 128/276 15 Claims, 5 Drawing Figures PATENTED'SEP 31974 ASP/PA TED VOL UME 1 MEDICAL ASPIRATION SYSTEM This invention relates generally to medical aspiration equipment, and to methods for preparing such equipment for proper surgical use. The invention will find particular application in uterine aspiration such asfor vacuum abortions or sampling of tissue for endometrial cancer detection.

Within the past seventeen years a technique called uterine aspiration or vacuum curettage has been developed for performing abortions during the early months of pregnancy. The earliest reference to this technique appeared in an article by Y. T. Wu and H. C. Wu, entitled Suction in Artificial Abortion- 300 Cases in the Chinese Journal of obstetrics and Gynecology, Vol. 6, 1958, beginning at page 447. A recent survey of the subject appeared in an article by Kerslake and Casey, entitled, Abortion Induced by Means Of Uterine Aspirator in Obstetrics and Gynecology, Vol. 30, July, 1967, pages 35-45. Very briefly, the technique described in the Kerslake and Casey article is to aspirate the conceptus from the 'uterus using a tube which has a flexible connection to a source of suction. A typical apparatus as described in the article includes a suction curette having an oval mouth at its end, or on one side, and an air hole at the other end to control the suction. A rubber suction tubing connects the curette to a glass container which in turn is connected to a source of suction. Aspiration of the uterine contents usually takes less than 2 minutes and the fetal material can readily be seen as it appears in the glass container. The method employed may be very briefly reviewed. The perineum, vagina, and cervix are disinfected. The cervis is then drawn forward with atenaculum. The direction of the cervical canal and the depths of the uterine cavity are determined with a uterine sound. It is a common practice to dilate the cervix to allow easy insertion of the suction curette. When dilation is required, preferably a local anesthesia is administered. General anesthesia is rarely used. The suction curette of appropriate diameter and design is inserted carefully through the cervix into the uterus. The suction is then started. in a few seconds the suction reaches a working level which, according to the Kerslake and Casey article, is at a mean level of 18 inches of mercury (relative). The suction curette is moved gently up and down over all aspects of the uterine cavity. The products of conception pass visibly into the glass container either whole or piecemeal. The degree of suction can be controlled with some aspirators by putting a thumb over an airhole at the base of the curette as well as by using a pressure control device on the pump. During the aspiration process, the uterus reacts by contracting and decreasing in volume. Aspiration usually takes less than a minute or two. his thought to be complete when the uterine wall fells smooth and no further remnants emerge. A TYPI- CAL PRIOR ART APPARATUS used for uterine aspiration consists of a curette connected by a hose to a collection bottle which in turn is connected by a second hose to a vacuum source.

In the prior art system described .by Kerslake and Casey the source of the vacuum or suction, the collection bottle, and the curette of cannula, are connected by hoses or pressure tubing. The working level of vacuum or suction typically is 15 to 18 inches of mercury (relative) and is gradually raised to this level after the curette is inserted into the uterus.

Uterine aspiration, is not limited to abortions, but is a general technique with a further application in diagnostics. For example, in a recent article by B. A. BJerre, et al., entitled Aspiration curettage A New Niagnostic Meth in the Journal of Reproductive Medicine, Vol. 7, No. 5, Nov. 1971,- the technique of aspiration curettage was recommended for routine use in collecting tissue for endometrial diagnosis and other diagnostic purposes. Here the curette is of a small outside diameter, typically 3mm, welded to a plastic cap of a tubular chamber which in turn is connected to a suction pump. The plastic chamber contains a perforated'plastic cylinder that serves as a filter and arrests mucosa] fragments which are to be laboratory tested for either polyps, endometrial atypia, or an adenocarcinoma. The technique employed in the diagnostic aspiration curettage is similar to that employed for the abortions by vacuum curettage. Here the vagina and portico are cleaned, typically with soap. The portico is gripped with a tenacucoum forceps; a uterine sound is passed in the cervix and without further dilation the eurette is advanced into the fundus. Suction is introduced and the curette is passed over the entire uterine walls; tissue and some blood is scraped from the uterine wall and aspirated by suction. The tissue is trapped in the tubular chamber and a histopathological examination is subsequently done on the aspirated and trapped tissue.

In one embodiment of the present invention a high vacuum is used, e.g., 28 to 30 inches of mercury, which is applied with full strength at the very beginning of the procedure. By using this high vacuum, it is possible to construct an aspiration system in which the collection bottle, source of vacuum, and handle for the. curette are all' one. This does away with a separate source of suction, whether that be an electric pump (which is commonly used in the United States), or a vacuum jar (as used in China). It might be noted that electric pumps are subject to failure due to electrical interuptions, or to accidental carry-over of fluids from the collection bottle --'with the very serious consequence that the procedure is interupted and has to be completed by sharp D & C or in extreme cases by a hysterectomy. The system of the invention, moreover, does away with the prior art hoses which connect the curette to the collection bottle and the collection bottle to the suction source. These hoses encumber the physician. Furthermore, if the curette is not provided with a handle and swivel, which are heavy, it is difficult to rotate the curette in the uterus. This feature is considered very desirable by many surgeons. In the present invention there are no encumbering hoses, and the surgeon may rotate the curette easilywithout heavy swivels or other attachments.

In one embodiment of the invention, a high vacuum is induced in a transparent'bottle typically less than one-half liter in volume. A cap with a valve is mounted on'this bottle and a cannulaor'curette rigidlyfits into a seat on the valve. In a typical procedure, the cannula is introduced into the uterus, the valve is then opened and thefull vacuum rapidly sucks the products of conception from theinterior of the uterus. The surgeon may grasp the bottle in one or both of his hands and enough to be conveniently held in a surgeons hand. This size is possible because of 1 )THE INITIAL I-HGH VACUUM AND (2) the absence of hoses, which dilute residual vacuum by reason of expansion, and (3) the discovery that the material extracted from the uterus is a fluid with virtually no gas content. The latter point might be examined a little more fully. The products of conception extracted from the uterus is a fluid with entrained semi-solids. This apparently was not previously appreciated, nor was it applied to the practical design of uterine aspiration apparatus- Experimentation has confirmed that the collection bottle may be filled approximately 70 full with aspirated material before the pre-induced vacuum level falls more than 12 percent. (In one measurement, a 475 milliliter container starting with an initial vacuum of 28.64 inches of mercury was filled to 400 milliliters and had a remaining vacuum of 26.85 inches of mercury. When subsequently filled to 450 milliliters, it still had 23.34 inches of mercury vacuum). The important point is that it is not until the aspirated volume reaches about 70 percent of collection bottle volume that the initial induced vacuum begins to deteriorate appreciatly. This fact apparently had not been appreciated nor was it applied heretofore to uterine aspiration systems.

A further advantage of the system of the present invention is that the aspirated products may be easily observed by the physician because the collection bottle is attached directly to the cannula and is in this hand during the procedure. In prior art abortion systems the collection bottle is remotely positioned. When connected by a hose, the collection bottle in order to avoid being accidentally toppled over when the hose was pulled on is securely mounted onto a stable platform 1 which is usually some distance away and the physician has to look up and away from the patient and the point of operation to see the aspirated material. With the apparatus of the present invention, the doctor applies his sense of touch to the collection bottle, and also concentrates visually on the collection bottle to observe the products of conception being removed.

A further advantage of the present invention, is lack of dependence on the electric vacuum pump. In addition to mechanical failure, possible contamination, and electric power failure, the pump has the further drawback in that its noise is psychologically upsetting and stress-producing on the patient. It has been observed that when the'pump is turned on and running, the patient reacts with an undesirable tension, complicating the emotional, as well as the physical completion of the operation. The system of the present invention it will be noted is completely silent.

It may be noted that this embodiment of the invention has the further advantages of being compact in that it occupies but a small volume, and it is simple-to assemble, disassemble and clean as well as to operate.

The initial vacuum in the bottle of this system may be induced by an electric pump, or by any other mechanical means. A preferred method according to the present invention of producing a very high vacuum, e.g., 28-30 inches of mercury in the collection bottle itself includes the steps of placing a small amount of water inside the bottle, heating the water so as to cause it to boil and fill the jar with saturated steam, thereby driving the entrapped air out of the bottle, then closing the valve on the bottlecap to trap the steam, and then cooling the steam and bottle. As. the steam con:

denses a nearly perfect vacuum is produced. This method may be employed in those areas where electric or mechanical pumps are inconvenient or untenable. It may find particular application in emergency situations, or in areas where electricity of appropriate characteristic is unavailable. The only requirement for producing high vacuum by this method is enough heat to boil water. It may be further noted that this preferred method sterilizes the collection bottle, as well as the valve fitting through which the steam is i jfl .A a... c

When the thermodynamic method of forming a high vacuum is used, the apparatus of the present invention may include a relief valve for'permitting the steam to escape, and various modifications and embodiments of such relief valves are described herein.

A further aspect of the present invention is a novel filter or trap for collecting the semi-solidparts extracted during an aspiration. The novel trap has the advantage of both a flexible trap, as well as a rigid trap. The advantages of the former are that it can be easily emptied so that the solid parts may be spread out in a pan to perform the fetal parts count. The novel trap may be disconnected and set aside should the surgeon decide that he does not wish to use a trap.

The novel trap is particularly useful with the high vacuum available with the apparatus of this invention in that the solid and liquid parts are drawn into the collection bottle at a high velocity, thereby moving the solid parts into the bottom of the trap and away from the entrance to the collection bottle.

Other objects and features of the invention disclosed will become apparent to those skilled in the art upon reference to the following specifications and accompanying drawings wherein several embodiments are disclosed by way of illustration.

IN THE DRAWINGS FIG. 1 is a plane view of a preferred embodiment of the invention, and auxiliary apparatus that may be used therewith.

FIG 2 is a perspective view of a partially assembled trap for use in the apparatus of FIG. 1.

FIG. 3 is a graph illustrating the relation between pressure (vacuum) remaining in the bottle in tenns of fluid volume aspirated.

FIG. 4 is a perspective view of an alternative embodiment of a portion of the cap valve socket assembly of FIG. 1.

FIG. 5 is a cross sectional view of a detail of the assembly of FIG. 4. I

Referring now to the drawing of FIG. 1,. there is shown a preferred embodiment of a collection apparatus of the invention, which will find typical application in terminating early pregnancies. The apparatus consists basically of three parts: a collection vacuum bottle, 10, a cap valve socket assembly, 12, and a mesh filter or trap, 14. A cannula l6, fits directly into a socket connection on the cap valve socket assembly, 12. Two accessories are also shown in FIG. 1. The first is a floating relief and check valve, 18, which may be used when the vacuum in the collection bottle is to be produced thermodynamically, as described more fully below. The second, is a test gauge, 20, to measure the vacuum in the collection bottle, and which ismore fully described below.

The collection bottle itself, 10, is preferably made of a clear (i.e., transparent) heat resistent material (e.g., Pyrex). The dimensions of the collection bottle are such that it may be conveniently hand-held. A preferred bottle has a lower portion, 22, which is larger than its upper portion, 24. A checkered or textured surface, 26, may be provided on the lower portion, 22, of the bottle, to facilitate gripping. A typical bottle is 6V2 inches long, with the upper portion 2%. inches in diameter and the lower portion 2% to 3 inches in diameter. During a procedure that the bottle is held in one hand and manipulated. Alternatively, the surgeon may loosely hold the upper portion in one hand, and graps the lower portion with his other hand, swivelling the apparatus so as to move the cannula tip over the wall of the uterus. It should be noted that the assembled apparatus includes the cannular rigidly connected to the collection bottle so that the bottle in addition to being the collection chamber, and the reservoir of the vacuum, is also the handle for the cannula. It should be further noted that the collection bottle during the procedure is in the hands of the surgeon and the extracted products of conception can be readily viewed through its transparent walls by the doctor as he performs the operation.

The upper end of the bottle terminates in a screw fitting, 28, which mechanically mates with a corresponding fitting on the cap valve socket assembly, 12. It

"should be understood, however, thataiiy convenient or conventional fitting may be used so long as the connection is vacuum tight, and for certain embodiments, are also heat resistent.

The cap valve socket assembly, 12, includes a cap portion, 30, which connects to the screw thread, 28, on the upper portion of the bottle. A plug valve, 32, is mounted on the cap, 30, and terminates in a suction curette socket connection, 34. The cannula or curette, l6, fits directly into the socket connection, 34, and is secured tightly therein by either a friction fit, as is common with many curettes commercially available, or by any other convenient or conventional securing means. The plug valve, 34, includes a handle, 36, which is movable between first and second positions to permit, or to block, a freeflow having at least inches diameter passage from the socket connection at 34, to the interior of the bottle at the inside of the cap, 30.

The mesh filter or trap, 14, may be a rigid plastic or metal mesh strainer which fits inside the collection bottle, and may be attached either to the inner face of the cap, or along the interspace between the cap and the top lip of the bottle. In practice, the traps collect the fetal parts and other solid material which are subsequently examined by the surgeon or pathologist. In the case of endometrial tissue collection, it is this tissue material which is sought for the subsequent diagnostic testing. In the case of abortion the semi-solid material is examined to make sure all of the products of conception have been removed.

A preferred trap, constructed in accordance with this invention, is shown in perspective,-partially assembled, in FIG. 2.

The trap includes a transparent cylindrical tube, 40, opened at both ends, and provided with an outwardly protruding lip, 42, at its upper edge. Atube receiving clip, 44, is mounted on the inside of the cap, 30, encircling the lower end of the flow through passage, and shown here as 46. The clip, 44, may be a resilient plastic which engages and firmly grips the lip, 42, on the tube, 40, thus rigidly holding the tube onto the cap,-30. A loosely woven tubular-shaped fabric, 48, open at its upper end, and closed at its lower end, is positioned inside the tube, 40. The upper end is folded over the upper lip, 42, extending approximately a half an inch down from the top. The fabric,48, is held in place by either the natural spring of the fabric itself, or by a rubber band or piece of string around the folded over fabric. The tube with the fabric over its upper end fits onto the receiving clip, 44, on the cap. The lower end of the fabric which is closed extends past the lower end of the tube. During an operation, solid matter which is aspirated, is retained in the fabric, 48, while liquid readily passes therethrough. With this arrangement the advantages of both the flexible and rigid collection traps are achieved. The tube, 40, holds the fabric, 48, in the proper spacial position inside the bottle, while preventing both clogging of the inside of the flow through passage by the fabric and accumulation of collected material at the passage opening, 46. The aspirated solids are in the flexible fabric, 48, and the surgeon after he believes all the products of conception have been aspirated, but while the patient is stillin the operating room may open the collection bottle, snap off the tube, 40, with the fabric, 48, pull out the fabric, 48, and turn it inside out, thusvery rapidly freeing all the solid material. The fetal parts count is then performed, with the surgeon determining whether all material has been extracted, and if necessary, he can go back and remove any remnants which were missed. The speed with which the filter can be emptied, coupled with the structure tht does not clog the filter, are thought to be important.

In a typical procedure, the trap, 14, is connected and the cap assembly, 12, is attached to the bottle, 10 (with the handle, 36, in the open position). Vacuum is induced inside the bottle, 10, the handle, 36, is closed. A sterile cannula, 16, is fitted into the socket, 34, and the apparatus is ready for the procedure. After the patient has been prepared, the cannula is introduced into the uterus, and the surgeon opens the valve, 34, at the handle, 36; and then, by manipulating the bottle,- 10, with one or both hands, moves the opened end of the cannula over the surface of the uterus wall, extracting the conceptus. When all the material is believed to be removed, the handle, 36, is closed, and the apparatus is removed. In the case of endometrial tissue extraction, a similar routine is followed.

The vacuum inside the bottle, 10, maybe produced immediately before the operation, by an electrical or mechanical pump. Alternatively the apparatus may be vacuum pre-packaged with the vacuum induced several weeks or months before the procedure and the apparatus rests on the shelf until ready.

In a preferred method of the invention, the vacuum is produced thermodynamically and preferably shortly before the operation. The advantages of the thermodynamic process are many. First, a very high vacuum is obtainable, on the order of 28 to 30 inches of mercury (relative). Second, the technique sterilizes the entire apparatus. Third, the vacuum may be produced without the need for an external pump whether that pump be electrical or mechanical, and thus does not rely upon electrical power or a source of mechanical power. According to the preferred method, the valve cap socket assembly, 12, with the attached trap, 14, is separated from the bottle, 10, and several cubic centimeters of water (e.g., 2 to 4 ccs) are placed inside the bottle. The trap, 14, and socket assembly, 12, are replaced, and the handle, 36, is in the open position. Heat is applied to the bottle, 10, until the water inside boils and steam issues steadily from the curette socket, 34. At this point the apparatus is removed from the heat and the handle, 36, is quickly closed. As the assembly cools the condensing steam induces the" high vacuum inside the bottle, 10. The saturated steam produced during heating drives out the entrained air, and the steam when cooled, condenses to a very small volume. producing a very high vacuum. The heat may be provided from any source, such as a laboratory Bunsen Burner, an autoclave, or if used in the field, a portable heating source, such as a stemo heater, or a kitchen stove.

It has been discovered that the aspirated products have very little, if any, gaseous content, and the high vacuum pre-induced inside the collection bottle remains relatively stable until approximately 70 percent has been filled with liquid and semi-solid material. For example, with an initial vacuum of 28.43 inches of mercury a collection bottle was filled 73 percent full and the remaining vacuum was still 25 inches of mercury.

The relationship can be generalized and expressed mathematically as follows:

Pr [PaVf+ Ps (V Va)]/ [Vf+ (V Va)] where Pr Pressure (vacuum remaining in collection bottle for any amount of fluid volume aspirated).

P5 Initial pressure in collection bottle (pre-induced vacuum).

Pa Atmospheric pressure.

V volume of collection bottle.

Vf Free volume between suction tip opening and valve.

Va Fluid volume aspirated.

All Expressed in Absolute Units.

In the apparatus of the present invention the quantity Vf (the free volume between the suction tip opening on the cannula and the valve) is held to a minimum because there are neither hoses nor intermediate connection between the cannula and the valve to deplete the available vacuum. When Pr, (the vacuum remaining in the collection bottle) is expressed in terms of Va (the fluid volume aspirated) for any set of given conditions, it is found that Pr does not change appreciably until the fluid volume aspirated reaches about 70 percent of the collection bottle volume. Thus, relatively large volumes of fluid may be aspirated at nearly constant preinduced vacuum levels. This relationship is shown graphically in FIG. 3.

When the vacuum is produced thermodynamically,

verious modifications may be added to the apparatus. I

FIG. 1 shows the floating relief and check valve, 18, which fits into the socket connection, 34, and is placed in the socket connection, 34, just before the bottle is heated. The valve, 18, is of suflicient weight to remain in the recessed socket connection yet allow entrained air and steam to escape during the heating cycle. When the heat is discontinued, and the steam condenses, the valve, 18, is drawn tightly into the socket, 34, by vacuum, and air is prevented from entering the bottle. The apparatus isthen cooled, the handle, 36, is closed, and the valve, 18, is removed. With this arrangement, the valve, 18, closes at the right moment, and an attendant An alternative embodiment relief valve is shown in FIG. 4, which is a perspective view of a portion of the cap valve socket assembly. The handle, 36, is connected to a rotable spool, 50, which has first and second passageways, 52 and 54. The first passageway, 52, becomes aligned with a central passageway (flow through) of the plug valve, 32, when the handle, 36, is in the open position (as shown in this Figure). The second passageway, 54, is perpendicular to the first passageway and extends to one side of the spool, where a one-way valve, 56, is mounted in the side wall or housing of the valve, 32. This one-way valve, 56, is of a kind which permits passage of a low pressure air and steam from the inside of the housing to the outside of the housing, but which blocks the passage of air in the opposite direction. A detail of a cross-section of the oneway valve, 56, is shown in FIG. 5, and includes a spring loaded ball, 58, which presses against a seat or collar, 60. The one-way valve, 56, is of a conventional design and any other one-way valves which perform the same function may be used. The advantage of the valve arrangement of FIGS. 4 and 5 is that when steam is generated and the valve, 32 is in its closed position, (i.e., the handle, 36, rotated 90 downward-and forward in the drawing of FIG. 4 so that the spool 50 takes the position shown in FIG. 5 the steam and entrained air will pass through the second passageway, 54, into the large passageway, 52, and then through the one-way valve, 56. When the apparatus is cooled, the one-way valve, 56, will not permit the return of air and the bottle is thus effectively sealed and as the steam condenses, the vacuum builds. It is not necessary for an attendant to handle the hot apparatus, or close the hot valve.

A further accessory for use with the apparatus is shown in FIG. 1. It is the vacuum test gauge, 20, which has a conventional vacuum gauge, 70, connected to a lower mating plug, 72, which fits into the socket, 34. The available vacuum can be measured without the loss of any pressure, (other than the vacuum associated with the gauge, 20, which is negligable) by placing the plug, 72, in the socket, 34, and opening the handle, 36. The gauge, 20, is also provided with a bleeder control knob, 74, which permits the controlled introduction of ambient air into the collection bottle. With this arrangement the vacuum inside the bottle may be adjusted to a lower level, if desired, while monitoring the remaining pressure on the gauge, 70.

An alternative gauge, 80, is shown in, FIG. 1. It will find particular application with pre-packaged vacuums that may remain on the shelf for several weeks or months. Gauge 80,-is a non-porous elastic membrane, filled with a given quantity of gas. It is positioned inside the-bottle, 10. When there is vacuum in the bottle, the

membrane is completely inflated through the expansion of entrapped air sealed in at atmospheric pressure. As the vacuum decreases, the membrane correspondingly collapses. Thus, the size of the membrane, 80, provides a rough indication of the amountof vacuum remaining in the bottle. During a procedure, as the vacuum bottle fills, the gauge, 80, provides a continuous measure of remaining vacuum. This is possible because it is light and floats on top of any collected liquids, and is always readily visible.

Although the invention has been described with examples applicable to abortions, it is not so limited, and

may find application elsewhere. For example, where the apparatus is to be used for endometrial cancer detection, or for removal of cysts and drain other body cavities, different sized cannula, and difierent sized collection bottles may be used. For example for endometrial testing thecannula typically has an outside diameter of 3 mm (this may be contrasted with the cannula used in the early weeks of pregnancy of approximately 6 to 8 mm) and the collection bottle is small in size, typically having a volume of about 100 ml.

Thus there has been shown and described a, uterine aspiration system which is self-contained, easy to use and frees the doctor from the encumbrances of connecting hoses, swivels, etc. Furthermore, the collection bottle forms the handle of the curette and thus not only provides a good support, but also permits inspection of the extracted products during the'procedure. The apparatus of the invention moreover, does not depend upon an electric pump-as its source of vacuum during the operation, and thus is free from the noise, and the resulting psychological stress associated therewith and possibility of power failure. There'has also been explained that it is possible to perform the vacuum curettage with a relatively small volume high vacuum collection bottle There has also been described a preferred method of producing the high vacuum. This method does not rely upon electric pumps or mechanical pumps, and may be produced in areas where electricity, and machinery, is not available. The method is simple, and also sterilizes the equipment. It will find particular application in remote areas of the world, where electricity and electric pumps are not readily available. There has also been described various gauges, and accessory valves, for use with the apparatus of the present invention.

What is claimed is:

l. A vacuum curettage aspiration system for removing fluids and semi solids from a uterus comprising a collection bottle having a volume in the range of 50 to 500 milliliters; a cap connectable to said bottle; and an operator-operative valve mounted in said cap and having a seat forv receiving a cannula, said valve providing on/off flow though passage from said cannula receiving seat to the interior of said bottle of said curettage system for removing fluids and semi solids from the uterus.

2. An apparatus according to claim 1 wherein said collection bottle is made of a transparent material, and has such cross-sectional and length dimensions that it may be readily manipulated by one hand.

3. An apparatus accordingto claim 1 wherein said bottle has a smooth cylindrical neck portion adjacent to said cap, about 2 inches in diameter, and 2 to 3 inches in length; and a body portion about 2% and 3 /2 inches in diameter and 3 inches in length with a textured outer surface to facilitate gripping.

4. An apparatus according to claim 1 further comprising a tissue trap assembly mounted inside said collection bottle at one opening of said operator-operative valve.

5. A system according to claim 1 further comprising a negative pressure gauge for measuring the vacuum in said system having an input valve received in said cannula receiving seat and of such dimensions to hermetically fit'in said seat, the gauge measuring the vacuum in said bottle by opening said valve and further com- 10 l the passage of air into said vacuum bottle to lower-residual vacuum level while measuring the vacuum in said bottle. I t

6. A system according to claim 1 adapted for uterine aspiration and wherein said system has a vacuum less than 0.2 atmosphere at the commencement of a procedure. I

7. A system according to claim 6 wherein said bottle has a vacuum less than 0.1 atmosphere-at the commencement of a procedure.

8. A system according to claim 1 wherein said bottle has a capacity between 300 and 400 milliliters.

9. A system according to claim 1 wherein said bottle has a capacity between and 200 milliliters.

10. A vacuum aspiration system comprising a collection bottle; a removable cap connectable to said bottle; and an operator-operative valve mounted in said cap and having a seat for receiving a cannula, said valve providing on/off flow through passage from said cannula receiving seat to the interior of said bottle, said system further includes a one-way relief valve means for permitting the passage of entrapped air and steam from the bottle into the ambient atmosphere.

11. An apparatus according to claim 10 wherein said one-way relief valve means comprises a weighted check of such dimensions that it fits into said cannula receiving seat, whereby when said apparatus with the valve open is slightly filled with water and heated and steam is generated inside said bottle, said steam pushes entrapped air and steam against said weighted check and escapes, and when said apparatus is cooled, said weighted check is drawn tightly closed by atmospheric pressure through condensation of the steam inside said bottle.

12. A system according to claim lfl wherein said operator-operative valve has a housing with a central passageway extending from inside said cap to said cannula receiving seat, a transverse bore intersecting said central passageway, a spool 'ratatably mounted in said transverse bore having first and second passageways, and a handle connected to said spool for operatoroperatively moving said ratatable spool between a first and second position;

said one-way relief valve means includes a one-way valve connection extending from said transverse bore through said housing, said one-way valve permitting a unidirectional passage of gasses from said transverse bore to an outside of said housing; and

said first passageway of said spool having a diameter equal to, and having its axis coplanar with the axis of said central passageway, and providing said open flow throughpassage from said cannual receiving seat to said bottle interior with said rotatable spool in said first position, and blocking said flowthrough passage when in said second position; said second passageway of said spool extending from said first passageway to a side of said rotatable spool and providing another flow through passage from said inside of said bottle through said first passageway and said one-way valve to the outside of the housing with said rotatable spool in said second position. i 13. An apparatus according to claim 12 wherein the axis of said central passageway, said transverse bore and said one-way valve are perpendicular to one anprising an operator-operativebleeder for permitting other.

14. An apparatus comprising a collection bottle; a removable cap connectable to said bottle; and an operator-operative valve mounted in said cap and having a seat for receiving a cannula, said valve providing on/off flow through passage from said cannula receiving seat to the interior of said bottle; a tissue trap assembly mounted inside said collection bottle at one opening of said operator-operative valve; said tissue trap assembly includes a snap connection on the inside of said cap; a transparent tube connectable to said snap connection and extending into said bottle; and a gauze sleeve longer than said tube and extending therethrough, one end of said sleeve being folded over said snap connectable end of said tube and another end of said sleeve spheres at the commencement of a procedure. 

1. A vacuum curettage aspiration system for removing fluids and semi solids from a uterus comprising a collection bottle having a volume in the range of 50 to 500 milliliters; a cap connectable to said bottle; and an operator-operative valve mounted in said cap and having a seat for receiving a cannula, said valve providing on/off flow though passage from said cannula receiving seat to the interior of said bottle of said curettage system for removing fluids and semi solids from the uterus.
 2. An apparatus according to claim 1 wherein said collection bottle is made of a transparent material, and has such cross-sectional and length dimensions that it may be readily manipulated by one hand.
 3. An apparatus accordingto claim 1 wherein said bottle has a smooth cylindrical neck portion adjacent to said cap, about 2 inches in diameter, and 2 to 3 inches in length; and a body portion about 2 1/2 and 3 1/2 inches in diameter and 3 inches in length with a textured outer surface to facilitate gripping.
 4. An apparatus according to claim 1 further comprising a tissue trap assembly mounted inside said collection bottle at one opening of said operator-operative valve.
 5. A system according to claim 1 further comprising a negative pressure gauge for measuring the vacuum in said system having an input valve received in said cannula receiving seat and of such dimensions to hermetically fit in said seat, the gauge measuring the vacuum in said bottle by opening said valve and further comprising an operator-operative bleeder for permitting the passage of air into said vacuum bottle to lower residual vacuum level while measuring the vacuum in said bottle.
 6. A system according to claim 1 adapted for uterine aspiration and wherein said system has a vacuum less than 0.2 atmosphere at the commencement of a procedure.
 7. A system according to claim 6 wherein said bottle has a vacuum less than 0.1 atmosphere at the commencement of a procedure.
 8. A system according to claim 1 wherein said bottle has a capacity between 300 and 400 milliliters.
 9. A system according to claim 1 wherein said bottle has a capacity between 100 and 200 milliliters.
 10. A vacuum aspiration system comprising a collection bottle; a removable cap connectable to said bottle; and an operator-operative valve mounted in said cap and having a seat for receiving a cannula, said valve providing on/off flow through passage from said cannula receiving seat to the interior of said bottle, said system further includes a one-way relief valve means for permitting the passage of entrapped air and steam from the bottle into the ambient atmosphere.
 11. An apparatus according to claim 10 wherein said one-way relief valve means comprises a weighted check of such dimensions that it fits into said cannula receiving seat, whereby when said apparatus with the valve open is slightly filled with water and heated and steam is generated inside said bottle, said steam pushes entrapped air and steam against said weighted check and escapes, and when said apparatus is cooled, said weighted check is drawn tightly closed by atmospheric pressure through condensation of the steam inside said bottle.
 12. A system according to claim 10 wherein said operator-operative valve has a housing with a central passageway extending from inside said cap to said cannula receiving seat, a transverse bore intersecting said central passageway, a spool ratatably mounted in said transverse bore having first and second passageways, and a handle connected to said spool for operator-operatively moving said ratatable spool between a first and second position; said one-way relief valve means includes a one-way valve connection extending from said transverse bore through said housing, said one-way valve permitting a unidirectional passage of gasses from said transverse bore to an outside of said housing; and said first passageway of said spool having a diameter equal to, and having its axis coplanar with the axis of said central passageway, and providing said open flow through passage from said cannual receiving seat to said bottle interior with said rotatable spool in said first position, and blocking said flow-through passage when in said second position; said second passageway of said spool extending from said first passageway to a side of said rotatable spool and providing another flow through passage from said inside of said bottle through said first passageway and said one-way valve to the outside of the housing with saiD rotatable spool in said second position.
 13. An apparatus according to claim 12 wherein the axis of said central passageway, said transverse bore and said one-way valve are perpendicular to one another.
 14. An apparatus comprising a collection bottle; a removable cap connectable to said bottle; and an operator-operative valve mounted in said cap and having a seat for receiving a cannula, said valve providing on/off flow through passage from said cannula receiving seat to the interior of said bottle; a tissue trap assembly mounted inside said collection bottle at one opening of said operator-operative valve; said tissue trap assembly includes a snap connection on the inside of said cap; a transparent tube connectable to said snap connection and extending into said bottle; and a gauze sleeve longer than said tube and extending therethrough, one end of said sleeve being folded over said snap connectable end of said tube and another end of said sleeve being closed and protruding from the opposite end of said tube.
 15. A vacuum curettage aspiration system for removing fluids and semi solids from the uterine cavity consisting of a hermetically tight collection bottle having a volume in the range of 50 to 500 milliliters and cap and having an operator-operative valve mounted in said cap, and said valve including a seat for receiving a cannula and providing on/off flow through passage from said cannula receiving seat to said collection bottle, said system having a vacuum less than 0.1 atmospheres at the commencement of a procedure. 